Author: Jon Otter (@jonotter)

It’s time for a mini-revolution in scientific publishing: a truly universal manuscript format

Jon Otter (@jonotter) publishing , ,

There’s a problem with academic publishing. This could be (but isn’t) a post about the lottery of peer review, the scandalous mountain of largely unpaid reviewing and editorial work that journals benefit from, the urgent need to adopt open access, or the interesting dynamics introduced by pre-print servers. Instead, this post is about a big problem with an easy solution: hours and hours of expert scientific time (and with that, grant money) currently being wasted reformatting manuscript for the initial submission to various journals. The solution: create and implement a truly universal manuscript format for the initial submission.

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Evaluating the value of multidisciplinary reviews to get to the root causes of C. difficile infection

Jon Otter (@jonotter) C. difficile , , , ,

An interesting paper has been published evaluating the cost and value of multidisciplinary team (MDT) meetings to investigate C. difficile cases. The study counts the cost of C. difficile MDTs (somewhere between £25k and £50k over two years), and concludes that they had limited value in delivering additional learning or quality improvement. But I beg to differ…!

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Planning to halve GNBSI: getting to grips with healthcare-associated E. coli BSI sources

Jon Otter (@jonotter) GNBSI , ,

Today, the Journal of Hospital Infection have published an article from our research group about E. coli BSI sources. The key message is that the sources of E. coli BSIs at a large teaching hospital differ considerably from the national average, with a large proportion related to febrile neutropaenia (18%) and diverse gastrointestinal sources (15%). This calls into question the ‘preventable’ proportion of these cases – and adds something to the discussion as to whether the national ambition to halve GNBSI by 2021 is feasible.

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Beware Biofilms!

Jon Otter (@jonotter) Biofilm , , , ,

Have you ever wondered how on earth vegetative bacteria can survive on dry surfaces for years? Or why when you have an outbreak and you swab the environment you don’t find the outbreak strain even though you’re pretty sure it’s there? Or why a disinfectant that gets a 4-log reduction in the lab can’t eliminate a couple of hundred cfu of bacteria from a dry surface? Dry surface biofilms could be the answer to all these questions! I was involved in a multicentre survey of dry biofilms from across the UK, and we identified dry surface biofilms on 95% of the 61 samples there were tested. Worryingly, viable MRSA was identified on 58% of the surfaces! We need to think carefully about how much of a risk dry surface biofilms present, and whether we need to do more to tackle them.

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Evaluating the economic value of the CDC CRE Toolkit

Jon Otter (@jonotter) CRE , , ,

Continuing the theme of CPE (or CRE if you prefer) Toolkit evaluation, a US research group has performed a modelling study to evaluate the economic impact of the US CDC CRE Toolkit. Curiously, whilst all approaches generated cost savings eventually, hospitals acting independently rather than as a co-ordinated region resulted in faster but ultimately smaller cost savings.

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Evaluating the CPE Toolkit

Jon Otter (@jonotter) CRE , , ,

A research group at Bristol in collaboration with PHE have just published an evaluation of the CPE Toolkit. I don’t think any of the findings are especially surprising, confirm that the Toolkit is not implementable in acute NHS hospitals, but provides useful information and guidance to build a local CPE policy.

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Making terminal disinfection BETR part II: another perspective

Jon Otter (@jonotter) Decolonisation , , ,

Marc recently posted about the second clinical outcome findings from the BETR-D study, recently published in the Lancet Infectious Diseases. Marc contended that the team may have been ‘blinded by the [UV] light’ in reaching the conclusion that enhanced terminal room disinfection led to a hospital wide reduction in acquisition of key pathogens. Here, in the spirit of healthy academic debate, I offer another perspective.

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The days of serial admission screening for CPE are numbered

Jon Otter (@jonotter) CRE , , , ,

The current national guidelines for CPE in England recommend three serial admission screens each separated by 48 hours to confirm a negative carrier status combined with pre-emptive isolation. Even leaving aside the infeasibility of pre-emptive isolation, this approach introduces a host of operational challenges. In a study just published in JHI, we find report that serial admission screens do not improving the detection of CPE. However, there was a striking apparent increase in the rate of carriage of other resistant Gram-negative bacteria in the early days of hospital admission, suggesting either an unmasking of pre-existing carriage or acquisition of resistant Gram-negative gut flora.

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The inaugural Healthcare Cleaning Forum

Jon Otter (@jonotter) Cleaning , , ,

Today was the inaugural Healthcare Cleaning Forum. The plan was to showcase some healthcare cleaning and disinfection science at the Interclean Conference in Amsterdam (which is a huge general cleaning show). I think we managed to create some awareness about the unique challenges of cleaning and disinfection in healthcare outside of the usual crowd.

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Should we disinfect the loo BEFORE flushing?

Jon Otter (@jonotter) Disinfection , , , , ,

There is a risk that an infectious aerosol is produced when toilets are flushed. One way of addressing this would be to add a disinfectant to the toilet before flushing. But would this be safe and effective?

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